Doctor-patient relationships

I got to thinking about the different ways people interact with their doctors. My own style is to diagnose myself, then tell the doctor what I want. (One physician’s assistant told me, “I love it when patients tell me what they want!”) I wondered about the nature of the doctor-patient relationship in cases where the patients themselves were doctors, so I asked a couple of friends who are doctors (both are long retired).

Dick, a psychiatrist, was raised in an environment in which “the doctor was revered and the patient was dutifully respectful and deferential.” After becoming a doctor himself, he struggled with such roles, mostly because he “did not feel as omniscient” as patients may have perceived him to be. Because he still has a “life-long deference to ‘authority figures,’” it makes it difficult for him to settle into a peer-to-peer relationship with a doctor. At the same time, Dick says, “I feel comfortable saying that I don’t understand something (common issue, actually) and asking for a more detailed explanation.”

Before making an appointment, Dick does an internet search of the provider, looking for “level of training, where trained, awards given, research papers published, etc.,” as well as common experiences that may “form the basis for rapport.” To ensure there’s no problematic bias, Dick holds off on letting the doctor know his profession. Once in a relationship, Dick reports that about 25 percent of his MD/MD relationships become collegial, and the remainder are “various shades of cordial professional interactions.” At the same time, he reports that he doesn’t “stay with an MD who makes me uncomfortable, even if he/she seems quite competent.”

Bob, an internist, tells me that for the most part he has “an excellent relationship” with his doctors and that he probably gets more time and attention than the average patient." For his appointments, he brings a list of any history and symptoms that may have developed since his last visit. Because Bob's medical practice ended many years ago, his doctors "know that how I practiced was how they would ideally like to practice.” He finds that “all of my doctors want to complain about the difficulty of practicing medicine nowadays.” Particularly maddening for them are today’s requirements for “checking the right boxes,” meaning filling out forms and using the right key words needed to get paid by Medicare and insurance companies—documentation that “may be more important than accurately documenting the patient’s health.”

Bob considers his doctors to be friends, but not socially. He has each of their home and personal cell numbers in case of emergencies, and that “they would be more likely to come to see me in the hospital, although that is not even allowed in today’s world.” When he was a practicing physician, he was “honored to have a doctor choose me as their physician” as it showed they valued his judgment and his standing in the medical community.  

It occurs to me that the dynamics at play in the doctor’s office may accurately reflect a core component of your psychological makeup (also the doctor’s). Think about it and analyze yourself!

For an introduction to this blog, see I Just Say No; for a list of blog topics, click the Topics tab.